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How do you improve the monitoring of high-risk pregnancies, and make it less expensive?

Pregnancy monitoring: home is where the heart is
Monitoring the pregnancies of women with health issues is vital to prevent child mortality. But this form of healthcare is also very expensive. Telenatal and BMA, ICT Group’s IT healthcare specialist, have developed a way to improve monitoring and make it less expensive.

Pregnant women suffering from obesity, high blood pressure or other medical conditions have to make regular hospital visits for check-ups on the health of both mother and baby. At the hospital, medical staff use a cardiotocograph (CTG) to measure the heartbeat of the foetus and any signs of contractions in the mother-to-be. This CTG reading may be reason to admit the mother to the hospital, so this kind of monitoring helps to prevent maternal and infant mortality.

Home monitoring
The trip to the hospital and arranging for someone to take care of the other children can themselves be very stressful for the mother, which in turn increase the risk of complications. To prevent that, hospitals are switching to home monitoring as often as they can. These check-ups – referred to as tele-monitoring – can also be carried out by primary carers such as midwives and specially trained nurses.

BMA, ICT Group’s supplier of obstetrics-related software products and services, and Telenatal already offer home-monitoring solutions. Specialised nurses visit pregnant women at home to carry out CTG scans using mobile CTG units. They then use a laptop to upload the information to the hospital’s patient records. Thanks to this home-monitoring, mothers-to-be no longer have to travel to the hospital, reducing the stress for the patient, and the risk of complications.

Sense4Baby
A new product that makes the home-monitoring of medical pregnancies both easier and less expensive was launched in 2013: Sense4Baby. This home-monitoring set consists of a handheld CTG device that registers foetal heartbeats and contractions, plus a smartphone or tablet, which can be used to send the data to the hospital’s patient records via the cloud. Thanks to Sense4Baby, pregnant mothers can do their own monitoring, without any help from a nurse or midwife. Specialists at the hospital can check the readings via a web portal. The CTG readings can also be added to the patient records in the hospital system via a separate interface. This could be in the Mosos system of BMA

Total solution
The Sense4Baby product was developed in the US and brought to the Netherlands by Telenatal founders Marco van Elst and Chris Kerkhof. However, the product was far from being a total solution for hospitals. ‘For instance, Sense4Baby had to fit into the overall healthcare process and comply with privacy legislation’, Van Elst explains. ‘Because this was a completely new territory for us, we looked around for a company that could help us and that turned out to be BMA. They know the hospital healthcare sector like the back of their hand, are deeply involved in obstetrics and have a lot of experience with CTG monitoring; their Mosos CTG is the standard in the Netherlands.’ Alex Holsbergen: “Telenatal worked closely with BMA on the further integration of the hardware and software to create a total solution they could offer hospitals. The far-reaching collaboration between BMA and Sense4Baby eventually led to the recent foundation of a new entity: BMA Telenatal BV.”

Business case
But the development of the total solution was far from the biggest challenge; that turned out to be selling the Sense4Baby to hospitals. Marco van Elst: ‘It took a lot longer than we thought it would to convince hospitals that the Sense4Baby was the right product. That was partly due to the fact that the medical world tends to go for proven technology rather than innovations, as they know proven technology works. It also took quite a while to demonstrate the Sense4Baby business case for hospitals; we had to convince them that the investment in Sense4Baby would pay off. The fact that in many hospitals obstetrics actually costs more money than it brings in makes this even more urgent.’

Demo hospital
‘In the end we had to set up a demo hospital to convince the hospitals. We managed to do that in 2014, thanks to BMA’s contacts. We knew that the University Medical Centre (UMC) Utrecht was interested, so we got together to discuss the potential of Sense4Baby. We were very open with each other: they provided us with a lot of information on the cost and income side, while we were very honest about our cost price and margins. And it was on that basis that UMC Utrecht chose to work with Sense4Baby.’

Roll-out
UMC Utrecht is now happily using Sense4Baby and did indeed prove to be an outstanding practical business case for Sense4Baby. Sense4Baby now has multi-year contracts with 10 hospitals and 40 midwifery practices in the Netherlands. ‘The experiences of both the hospitals and the mothers have been very positive, says Van Elst. And now there is interest in Sense4Baby outside the Netherlands. ‘That is a market with enormous potential. Obviously because of the sheer scale of the market, but also because healthcare is private in a lot of countries. And because hospitals charge on the costs of the Sense4Baby device to their patients, there is an even clearer business case for our product.’

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